Joint Medical Support: Are We Asleep at the Switch?

The terrorist bombing of the Marine barracks at Beirut airport in 1983 prompted a detailed evaluation of the medical structure available to support similar incidents as well as a conflict in Europe. Some of the medical capabilities probed were command and control, casualty evacuation, regulating procedures, facilities capabilities, the transition from routine peacetime to contingency operations, and efficacy of readiness planning. While no life was lost that could have been saved, if the ratio of killed to wounded had been reversed, with more than 200 in need of treatment rather than only half that number, the system might have failed. Has the intervening period enabled us to assess such shortcomings, adapt to a new security environment, and offer prompt, consistent care? Analyses of the Beirut bombing revealed deficiencies in readiness caused by shortages in personnel, evacuation assets, and materiel, as well as lack of joint planning for their wartime use. Such deficiencies were attributable to the low priority that medical readiness is given in planning, programming, and budgeting. Recommendations included greater investments in basic readiness resources and refinement of mechanisms for effecting command and control over wartime support and operating those assets. A worldwide reassessment of contingency medical capabilities ensued, and a template of principles for implementing joint support of combat operations evolved. Then Operation Desert Storm provided an opportunity to reassess progress in meeting readiness goals in contrast to the medical support provided in response to the Beirut tragedy. ; Published in Joint Force Quarterly (JFQ), p102-109, Summer 1995.